Neurocysticercosis (NC) is endemic in much of the developing world. It is a major cause of neurologic morbidity and is said to be the primary cause of epilepsy. Traditionally considered an exotic disease in the United States, NC is being seen with increasing frequency in the United States. This is related to immigration as well as travel to endemic area. NC accounts for 2 percent of neurologic and neurosurgical admissions in southern California and there are more than 1,000 cases per year in the United States. An outbreak of cysticercosis among orthodox Jews living in New York City was reported after food was contaminated with T. solium eggs by immigrant cooks infected with the pork tapeworm. The Center for Disease Control considers NC an emerging infection, and they are developing programs to track and hopefully eradicate the condition. While a considerable literature exists regarding treatment of NC, for most clinicians, decisions regarding treatment strategies present a serious dilemma. There are few randomized trials of the treatment of NC. These report conflicting results and raise serious questions regarding the efficacy of current treatments and the long-term cost-benefit ratio. None have adequate power to answer even basic questions regarding optimal management. We herein propose a pilot study to develop methods to conduct a multicenter trial to determine of optimal treatment of acute NC.
